Heart Bypass Surgery

Heart Bypass Surgery

Heart bypass surgery, also called “coronary artery bypass graft surgery” (CABG), is a procedure performed to improve blood flow to the heart. It becomes necessary when the coronary arteries, responsible for supplying blood to the heart, become narrowed or blocked. 


During CABG, healthy blood vessels from another part of the body are utilized and connected to blood vessels above and below the blocked artery. This establishes a new pathway for blood to flow, bypassing the narrowed or blocked coronary arteries. Typically, the blood vessels used for grafting are arteries from the arm or chest or veins from the legs.

This surgery is known by various names, including:

  • Coronary artery bypass grafting (CABG)
  • CABG is pronounced as “cabbage”
  • Coronary artery bypass graft surgery
  • Heart bypass surgery

CABG does not cure the underlying heart disease responsible for blockages, such as atherosclerosis or coronary artery disease. However, it can effectively alleviate symptoms like chest pain and shortness of breath. Moreover, this surgery may lower the risk of heart disease-related death.

Who performs heart bypass surgery?

A cardiac surgeon performs heart bypass surgery. It is performed in various hospitals and medical centers with well-equipped cardiac surgery departments.

Why is bypass surgery done?

Coronary artery bypass surgery aims to restore blood flow around a blocked heart artery, and it can also be performed as an emergency treatment for a heart attack when other immediate interventions are ineffective.

The doctor may recommend coronary artery bypass surgery if the patient has:

  • A blockage in the left main heart artery which is crucial for supplying blood to the heart muscle.
  • Severe narrowing of the main heart artery.
  • Intense chest pain is caused by narrowing several heart arteries, reducing blood flow even during light exercise or rest.
  • Multiple diseased heart arteries and impaired function of the lower left heart chamber.
  • A blocked heart artery that cannot be adequately treated with coronary angioplasty, a less-invasive procedure involving a catheter with a balloon or stent to widen the artery.
  • A history of failed angioplasty with or without a stent, such as re-narrowing of the artery after stent placement.

How is bypass surgery performed?

Before having coronary artery bypass grafting (CABG), a person must undergo thorough preparations and various tests to ensure the surgery is safe and suitable for them. These tests help the doctor’s team assess if CABG is the right option for the individual and if they are physically ready for the procedure.  These tests may include, but are not limited to:

  • Electrocardiogram (ECG)
  • Echocardiogram
  • Exercise stress test
  • Nuclear cardiac stress test
  • Cardiac catheterization
  • X-ray angiography or computed tomography (CT) scan angiography
  • Coronary calcium scan
  • Lab tests to analyze cholesterol, blood sugar, and other factors
  • Urine tests to assess kidney function
  • The doctor will also review the medications, advising which to continue and which to stop before the surgery. They might change the patient’s medication regimen or start on new medications as necessary.
  • Preparation for the surgery will be discussed, including arrangements for home support, dietary guidelines, personal grooming, and bathing protocols before the procedure.
  • Furthermore, the doctor will provide all the information about the post-surgery period, including the expected recovery timeline, potential symptoms to monitor, and overall expectations during the recovery process.
  • Written consent is signed by the patient or their family member after they have been provided with information about the surgery.

During surgery

Coronary artery bypass grafting (CABG) can be performed in different ways, with the most common being traditional bypass surgery. During this procedure:

  • Before the patient goes into the operating room, the nurse inserts an IV into the forearm or hand to give anesthesia.
  • The patient will be under general anesthesia, asleep throughout the operation.
  • A chest incision is made, and the breastbone is divided and held open during surgery.
  • A heart-lung bypass machine is often used, taking over the heart and lung functions during the procedure.
  • The surgery’s duration can range from 3 to 6 hours, depending on the number of arteries requiring bypass.
  • In some cases, less invasive approaches (smaller incisions) may be used, where the chest bone is not opened, based on the patient’s risk factors and the recommendations of the surgical team.

After surgery

After coronary artery bypass surgery, a team of doctors will monitor the patient’s well-being and ensure comfort. Upon waking up, the patient might feel sore and disoriented. Here’s what the patient can typically expect:

  • The breathing tube remains in the throat until the patient can breathe independently.
  • The patient will spend around 1 to 2 days in the intensive care unit, and the total hospital stay duration depends on the recovery and any potential complications. Some patients go home within a week after surgery.
  • The doctor’s team closely monitors the patient’s condition, recording breathing and heart rhythm. Frequent temperature checks are conducted.
  • IV medications are administered to manage pain and prevent complications like blood clots. The doctor may recommend daily aspirin use if the patient is not already taking it, but this decision will depend on the specific medical needs.
  • A supervised program called cardiac rehabilitation helps improve heart health post-surgery. It involves education, counseling, and exercise. The patient will be encouraged to start moving and walking while in the hospital and will continue the rehab program at a medical center.
  • After surgery, be vigilant for symptoms like fever, rapid heart rate, chest wound pain, changes in skin color around the wound, or any unusual bleeding or discharge. Contact the doctor if the patient experiences any of these symptoms.
  • The patient can usually resume driving, work, and physical activities, including sexual activity, after 4 to 6 weeks with the doctor’s approval. However, recovery can vary from person to person, so consult the doctor for personalized guidance.

What are the risks or complications associated with heart bypass surgery?

CABG is a major surgery; like any surgical procedure, it carries potential risks and complications. While many of these risks are preventable or manageable, it is crucial to be aware of them. Possible risks include:

  • An irregular heartbeat is called arrhythmia
  • Bleeding
  • Infections
  • Confusion or delirium
  • Kidney problems
  • Stroke
  • Heart attack


  1. Coronary artery bypass grafting. What is coronary artery bypass grafting? Available from: https://www.nhlbi.nih.gov/health/coronary-artery-bypass-grafting
  2. Cleveland Clinic. Coronary artery bypass surgery. Available from:


  1. American Heart Association. (2020). Coronary Artery Bypass Surgery (CABG). https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/coronary-artery-bypass-grafting-cabg

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